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NAN and Northern Ontario School of Medicine release report

Wednesday March 19, 2014

A community-based approach to establish emergency care services in isolated and remote First Nation communities has been identified in a new report from researchers at the Northern Ontario School of Medicine (NOSM).

“The majority of NAN First Nations are remote and residents do not have paramedics or first responders to call when emergencies arise, leaving people to fend for themselves in what are often life-threatening situations,” said Nishnawbe Aski Nation (NAN) Deputy Grand Chief Alvin Fiddler, who holds the health portfolio. “Community-based emergency care will go a long way to improving the health and safety of residents of isolated communities. We are looking for a strong commitment from the federal and provincial governments to put this approach into action.”

The report, titled “Community-Based Emergency Care: An Open Report for Nishnawbe Aski Nation,” outlines this new approach. Typically, remote communities have been too small to support conventional ambulance services. The report calls for local health workers and first-responders developed through local training programs for people living in isolated communities.

The first recommendation calling for the building a working group led by NAN and a collaboration with Health Canada and the Ontario Ministry of Health and Long-Term Care to roundtable vision, which would require funding considerations from government partners.

The second recommendation calls for the representation of key partners within the working group, including NAN communities, the Sioux Lookout First Nations Health Authority, Weeneebayko Area Health Authority, Health Canada First Nations and Inuit Health Branch, Aboriginal Affairs and Northern Development Canada, Ontario Ministry of Aboriginal Affairs, ORNGE Air Ambulance, The Northeast and Northwest Ontario Local Health Integration Networks, Sioux Lookout Regional Physician Services Incorporated, the Northern Ontario School of Medicine, university researchers, and the non-profit sector.

The third calls for following the guiding principles to advance community-based emergency care. The working group should be rooted in six guiding principles, including being community-based; sustainability; capacity building; collaboration; integration; and excellence.

The last recommendation is to plan and test a model for community-based emergency care.

The report stems from an October 2013 roundtable including leaders for NAN First Nations, provincial and federal government delegates and healthcare providers. It offers a vision, key recommendations and guiding principles with which to improve emergency care for injured and ill people in remote and isolated communities

“Community-based emergency care is about empowering and equipping locals to deliver the care that communities need,” explains Dr. Aaron Orkin, an assistant professor at NOSM and the lead author of the report. The report identifies how this approach can deliver excellent care, save lives, build healthier communities, and even create jobs and economic development opportunities. “We see real potential to bring excellent and efficient care to some of the most underserviced populations in Ontario.”

Approximately 29 First Nations in northern Ontario do not have access to 911 or paramedic services. Residents of First Nations face elevated rates of heart attacks, stroke, and mental health crises, and are four-times more likely to experience severe trauma relative to the average Canadian.


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